Provider Demographics
NPI:1528012523
Name:MADDUX, FRANKLIN W (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:W
Last Name:MADDUX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1040 MAIN ST
Mailing Address - Street 2:PO BOX 1360
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1816
Mailing Address - Country:US
Mailing Address - Phone:434-792-1433
Mailing Address - Fax:434-797-2807
Practice Address - Street 1:1040 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1816
Practice Address - Country:US
Practice Address - Phone:434-792-1433
Practice Address - Fax:434-797-2807
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043362207RN0300X
NC28721207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA171806OtherANTHEM
VA0071722OtherCIGNA
VA327789OtherMAMSI
NC809560KMedicaid
NC2007867AMedicare ID - Type UnspecifiedNC MEDICARE
NC809560KMedicaid
VA327789OtherMAMSI
VA171806OtherANTHEM